Little awareness of HIV among migrants in Iran

HERAT, 21 January 2009 (IRIN) - Ebadullah, aged 26, worked in Iran illegally for four years, but was deported on 3 January. Whilst in Iran he used sex workers and intravenous drugs - unaware of the risks of contracting HIV.

He is expected to marry and start a family, but is scared of doing an HIV test.

Every year hundreds of thousands of Afghans, mostly young single males, illegally cross the border into Iran in search of work, according to the government and the UN Refugee Agency (UNHCR).

Away from home for long periods, some turn to drug abuse or use the services of commercial sex workers.

“Both men and women sex workers are in abundance in Iran, and they’re not very expensive,” Ebadullah told IRIN in Herat.

“Among Afghan refugees [in Iran] the use of opiates, hashish and even heroin is common,” he said, adding that taking drugs intravenously was not uncommon.

Sharing needles is a very efficient way to transmit blood-borne viruses such as HIV, and has been found to be three times more likely to transmit the virus than sexual intercourse.

When asked whether he had thought about HIV, the young deportee paused and said: “I don’t know. They [young men] do not worry about diseases. Sex and drugs are rare pleasures and people don’t want to spoil them with worries about AIDS.”

Due to their illegal status in Iran, they have few opportunities to get educated on HIV/AIDS. Many are illiterate and therefore unable to read health messages.

Iran deported over 360,000 Afghans in 2008, according to government statistics.

Stigma, ignorance

Herat has one HIV Voluntary Counselling and Testing (VCT) centre but on average only five people visit it daily, health officials said.

“Social stigma and lack of awareness are major problems. People do not voluntarily visit our centre,” Mohammad Arif Shahram, the head of Herat’s VCT centre, told IRIN.

Among the 504 officially registered cases of HIV/AIDS in the country, 41 were reported in Herat Province in the past three years. Most of the 41 were infected in Iran, Shahram surmised, based on evidence he had seen at the VCT centre.

“HIV risk factors are higher in Herat than elsewhere in the country,” said Shahram citing large-scale trans-border movements and drug addiction as the most serious challenges.

However, little has been done to boost awareness of HIV/AIDS among migrants to Iran. Public health officials in Kabul and Herat said there was currently no project aimed at raising awareness among them.

Afghanistan kicked off its national HIV/AIDS control programme in 2003 and has received pledges of over US$30 million from donors up to 2013. The first-ever antiretroviral therapy for about 40 HIV positive people should start soon.

 Source: Integrated Regional Information Networks (IRIN), a project the Office for the Coordination of Humanitarian Affairs. IRIN is UN humanitarian news and information service, but may not necessarily reflect the views of the United Nations or its agencies.